Overview
Polyps of the larynx are benign mucosal lesions that can arise from vocal fold irritation, chronic inflammation, or trauma, often presenting with hoarseness or voice changes 1.Diagnosis
Clinical Presentation: Hoarseness, voice fatigue, and sometimes dysphonia 1.
Endoscopic Examination: Visualization of a smooth, often pedunculated mass on the vocal fold 1.
Laryngoscopy: Direct or videolaryngoscopy may be used for detailed assessment; videolaryngoscopy can improve visualization but may impact direct laryngoscopy skill acquisition 1.
Grading: Typically not graded systematically; size and impact on vocal fold function are assessed clinically 1.Management
Voice Therapy: Initial conservative approach focusing on vocal rest and behavioral modifications 1.
Surgical Intervention: For persistent symptoms or large polyps, microsurgical excision under direct laryngoscopy is often recommended 1.
Avoid Irritants: Minimizing exposure to irritants like smoking and excessive vocal strain 1.Special Populations
Pediatrics: Limited specific data; management focuses on conservative measures and voice therapy 1.
Elderly: Similar to general population, with emphasis on minimizing surgical risks and ensuring adequate post-operative care 1.
Comorbidities: Presence of conditions like GERD may require concurrent management to prevent recurrence 1.Key Recommendations
Initial Management with Voice Therapy: Prioritize voice rest and behavioral modifications for symptomatic relief (Evidence: Moderate 1).
Surgical Excision for Persistent Cases: Consider microsurgical removal for polyps that do not respond to conservative treatment (Evidence: Moderate 1).
Use of Videolaryngoscopy for Teaching: While videolaryngoscopy enhances visualization, direct laryngoscopy skills should still be taught to maintain proficiency (Evidence: Expert opinion 1).References
1 Gunning SGS, Urwin D, Cook TM, Hansel J. Videolaryngoscopy versus direct laryngoscopy for teaching direct laryngoscopy skills: a systematic review and meta-analysis. British journal of anaesthesia 2025. link